International Uptake on Partnering for Change P4C – The Joint Innovation Partnership for Learning (JIP4L)

Universell design

Insatser i form av miljöanpassningar såsom digitalt stöd och universell design för lärande
(UDL) har en potential att påverka delaktighet och måluppfyllelse i skolan för elever med
funktionsnedsättning och i behov av särskilt stöd. Trots satsningar för barn i behov av särskilt stöd finns en stor andel barn som har bristande delaktighet och engagemang, psykisk ohälsa och som inte uppnår kunskapsmålen.

Inkluderande lärmiljö

En inkluderande lärmiljö är en förutsättning för lärande, utveckling och god hälsa. Projektet
har teoretisk förankring i den miljörelativa och personcentrerade Model of Human
Occupation (MOHO) (Taylor, 2017). Människans engagemang, delaktighet och utförande i
aktiviteter förklaras som ett dynamiskt samspel mellan individens förmågor och
förutsättningar i miljön. Enligt modellen, erbjuder miljön potentiella möjligheter och
resurser, krav och begränsningar och utgör därmed en kritisk dimension som antingen
stödjer eller försvårar en elevs aktivitet i skolan och inverkar på elevens delaktighet och
välbefinnande. Skolmiljön ska ge barnen möjligheter att interagera med sina kamrater,
lärare, utbildning, material och aktiviteter. En central aspekt är utformning av skolaktiviteter och hur dessa kan genomföras på alternativa sätt. Över tid har det skett ett perspektivskifte från fokus på begränsningar i en persons förmåga till att fokusera på miljöhinder men det är fortfarande vanligt att när elever har svårigheter i skolan läggs problemet på individen [9].

Partnerskap – kunskapsbyggande

I projektet kommer en kanadensisk innovationsdriven skolbaserad intervention Partnering
for Change (P4C) implementeras och effekterna utvärderas i svensk skola där 4C står för
Capacity Building through Collaboration and Coaching in Context [2]. Modellen bygger på tvärvetenskapligt samarbete, partnerskap och kunskapsöverföring (capacity building) för att skapa en hållbar förändring som möjliggör för elever att klara kunskapsmålen.

JIP4L

The Joint Innovation Partnership for Learning (JIP4L) network connects Netherland and Sweden as global partners that are involved in transferring, developing and exchanging Partnering for Change (P4C) knowledge beyond the Canadian context from an international perspective. JIP4L aims are:

• Generation of collective new knowledge around Partnering for Change to combat exclusion and inequality for all children;
• Professionals’ (e.g. teachers) capacity building about inclusion, belonging and diversity by learning from each other in partnership;
• Creating inclusive environments by teachers and P4C experts on a national level and exchange of strategies on an international level;

Resource pack how to set-up the JIP4L network around capacity building and development; Workshops and life co-creation sessions as part of JIP4L partnership

The P4C – Partnership Continuum Model

In complex school environment with growing diversity, top-down leadership (e.g. buying external service providers for a short term) rarely improve capacity building among school professionals with regard to pupils participation and belonging. Instead, deeper partnerships between complementary professionals (e.g. teacher and occupational therapist), ones that jointly observe, reflect and act in the context for improving the learning journey, participation and belonging of all children, is warranted.  

The JIP4L has been inspired by the Partnership Continuum model (Toon & Jensen, 2017) including the following  types of collaboration: 1. Setting-up P4C innovation communities (WP1); 2. Basic partnerships, while experiencing application of P4C and building local innovation partnership for learning (WP2); 3. Collaborative partnerships (WP3), in which partners hold structured meetings that involve sharing experiences about the P4C application; 4. Continuously improving partnerships (WP4), in which partners collaborate on joint P4C projects; and 5. Coherent partnership (WP5), in which partners design, deliver, evaluate and improve the P4C approach. School system standards, motivations, and supports are all important in helping these partnerships to be deep, coherent, and continuously improving.

The JIP4L between the Netherlands and Sweden followed the process as described in the Figure 1.

Figure 1: The P4C- Partnership Continuum model

P4C adaptation and implementation beyond the Canadian context

The adaptation and implementation of the Partnering for Change Model beyond the  Canadian context took five major steps based on Barrera & Castro (2006) framework starting in 2013 in the Netherlands and in 2017 in Sweden. The major steps used to structure the process of the culturally grounded adaptations for the Dutch and Swedish context; they are shortly presented hereunder.

In the Netherlands, the first step (2013-2015) included information gathering about P4C, making agreements with CanChild and organizing an inspiration session with N. Pollock. The next step (2016- 2017) was  setting up a preliminary adaptation design protocol, including translation and back translation process, preparing educational materials and a first pilot. Then the phase with development & adaptation of research materials used in original Canadian study, a first small-scall pilot with 4 schools followed including qualitative study (1 (2017-2018). In this period 2 small grants (SIA – KIEM and Werkplaats) were received. Seeking and receiving funding (NordForsk project –no. 85644) enabled collaboration with a Swedish P4C team and starting with a PhD study of Sarah Meuser with a main aim to adapt and refine P4C for the Dutch context refinement (2019-2022). In 2022-2024 an international ERASMUS+ grant with Sweden – JIP4L project started and a small national grant  – LIME 2.0 have been received.

In Sweden, the orientation phase (2017-2019) included initial familiarization with the P4C, formulation of the P4C-team and stakeholders, seeking and receiving funding (NordForsk project –no. 85644) and starting the collaboration with the Netherlands. In 2019 the first adaption phase started where the Canadian education package (Partnering for Change OT Modules) were partly modified to the Swedish educational system. Preparations to conduct a feasibility study of P4C in Sweden started. In Preliminary adaption tests (c), the feasibility study was conducted. Furthermore, a qualitative study including P4C professionals from both Sweden and Netherlands was initiated. National grants were received. In step (d), further adaptions were performed based on the feasibility study, including new content in educational modules based on the Swedish context and planning for a network for P4C-professionals that support the sustainable implementation of P4C. In 2022, the Swedish P4C-team received a large national grant (FORTE) and an ERASMUS+ grant with Netherlands. Between 2022-2025 an intervention study, with controls, will be conducted in Sweden (https://partnering4c.se/).       

Evidence, Resources & Current Projects

Evidence:

• List of articles
• Barbara Piškur, Marjatta Takala, Anita Berge, Liselotte Eek-Karlsson, Sara M. Ólafsdóttir & Sarah Meuser (2022) Belonging and participation as portrayed in the curriculum guidelines of five European countries, Journal of Curriculum Studies, 54:3, 351-366, DOI: 10.1080/00220272.2021.1986746

• S. Meuser, B. Piskur, P. Hennissen & D. Dolmans (2023) Targeting the school environment to enable participation: A scoping review, Scandinavian Journal of Occupational Therapy, 30:3, 298-310, DOI: 10.1080/11038128.2022.2124190
  • S. Meuser, M. Borgestig, H. Lidström, P. Hennissen, D. Dolmans & B. Piskur (2022) Experiences of Dutch and Swedish Occupational Therapists and Teachers of Their Context-Based Collaboration in Elementary Education, Journal of Occupational Therapy, Schools, & Early Intervention, DOI: 10.1080/19411243.2022.2143465
• Baric V., Yngve M., Holmefur M., Feldman I., Wilder J., Johansen K., Klang N., Lidström H., & Borgestig M. A Collaborative Intervention to Create Inclusive Learning Environments for children at Risk of Mental Health Problems, Exclusion and Low Academic Achievements- a Study Protocol for Partnering for Change (P4C) in Sweden. (submitted).
• Yngve M., Baric V., Lidström H., & Borgestig M. Feasibility of a Collaborative Intervention “Partnering for Change” (P4C) to Create Inclusive Learning Environments in Swedish compulsory schools. (submitted).

List of presentations

• Piskur,B. (2023). Participation roadmap and the use of tacit knowledge: Partnering for Change xample, Arvo Ylppö seminar on 20th of April at Metropolia University of Applied Sciences, Myllypuro campus, Myllypurontie 1, 00920 Helsinki.
• Piškur, B., & Meuser S. (2022). Partnering for Change: The Dutch experience. Pre-conference workshop – 18. WFOT (World Federation of Occupational Therapists) Congress, Paris, France, August 28.-31
• Baric, V. (2023). Uppföljning av arbetsterapeutiska insatser för elever med bristande aktivitetsutförande i skolan- Partnering for Change (P4C) [A follow-up of Occupational therapy interventions for students with insufficient occupational performance at school – Partnering for Change (P4C)]. Arbetsterapi forum [National occupational therapy conference]. Digital conference. March, 14-15-  
• Lidström, H. (2022). Is the Occupational Therapy Intervention Partnering for Change (P4C) feasible for Swedish school contexts? WFOT (World Federation of Occupational Therapists) Congress, Paris, France, August 28-31.
• Piškur, B. (2022). Keynote speech: Partnering4Change: a transition in collaboration, EN congress 8th of October.
• Anaby, D., Piskur, B., Schakel, F., Imms. C., Dada, S., van der Holst, M., Khetani, M., Bedell, G., Simeonsson, R. & de Kloet, A. (2022). Let’s LEAP together: Towards a participation-focused practice and a pediatric rehabilitation paradigm shift. Combined 11th Australasia Academy of Cerebral Palsy and Developmental Medicine and the 3rd International Alliance of Academies of Childhood Disabilities Conference ’BETTER TOGETHER’ (AusACPDM / IAACD) 1 – 5th March 2022 at the Melbourne.
• Yngve, M. (2021). Partnering for Change (P4C) in a Swedish context. SWEDISH RESEARCH NETWORK FOR PARTICIPATION AND SCHOOL-BASED INTERVENTIONS.
• Borgestig, M (2021). Arbetsterapeutiska insatser till elever i skolan – genomförbarhet av den skolbaserade interventionen P4C. [Occupational Therapy interventions for pupils in school-feasibility of the school-based model P4C] National occupational Therapy conference [Arbetsterapiforum], Stockholm, Sverige.
• Meuser, S., van Dijk, K., van der Meer, P., & Piskur, B. (2021). Context matters: nieuwe interventies gericht op de omgeving. Jaarcongres Ergotherapie, Den Bosch, Netherlands.  

Book chapters:

• Piškur, B., Meuser, S., Hennissen, P. Politics of belonging: Promoting children’s inclusion in educational settings across borders. In: Hennissen, P. Broedplaats, Lectoraat de Nieuwste Pabo, Fontys & Zuyd 2019.
• Meuser, S., Piškur, B. Leerkracht en ergotherapeut in de klas: cross-over samenwerken. Professionalisering en ondersteuning van leerkrachten op de weklvoler. In: Hennissen, P. Broedplaats, Lectoraat de Nieuwste Pabo, Fontys & Zuyd 2019.

Joint international projects

• Joint Innovation Partnership for Learning (JIP4L)- ERSMUS+ project – KA210-SCH – Small-scale partnerships in school education (2021-2-NL01-KA210-SCH-000049804).
  • Politics of Belonging – NordForsk Project (no. 85644).
  • PhD project  The Netherlands:

Sarah Meuser Maastricht University (2020

Partnering for Change in Sweden

In Sweden an innovative and intersectoral collaboration research program using the Partnering for Change (P4C), a new model in the Swedish school context, is implemented and evaluated in Swedish Schools.

The overall purpose of P4C project in Sweden is:

• To increase pupils’ prerequisites for learning, participation and mental health by creating an inclusive learning environment. 
• To build capacity among teachers, occupational therapists (OT) and special education teachers about pupils with special educational needs (SEN).
• To create a supportive and sustainable network for capacity development through the national and international network JIP4L (CLICK here for JIP4L).
• To evaluate the cost-effectiveness of P4C.

Implementation of P4C in Sweden

The implementation of P4C has been studied systematically starting with an exploration phase (2017-2019), followed by a feasibility study (2019-2020), an adaption to the Swedish process (2021-2022), to an ongoing evaluation study (2022-2025).

Exploring P4C and Feasibility study (2017-2021)

The exploration and adaptation of P4C in Sweden started in 2017. In 2019 a feasibility study was performed to evaluate the feasibility and acceptance of P4C, the chosen outcome measurements and weather the P4C needed to be modified to be applicable in the Swedish context.

The results of the feasibility study were positive and showed that P4C was feasible in Swedish school. P4C was considered as an attractive and applicable approach to create supportive and inclusive learning environments.

The Joint Innovation Partnership for Learning (JIP4L) network (2022-2024)

From the feasibility study, the Swedish team recognized that teachers, schools and organizations might require time and continuous support during the implementation of P4C. As such, the Joint Innovation Partnership for Learning (JIP4L) network (Click back to JIP4L), with The Netherlands will be used as a support structure for local implementation of P4C, as well as to spread the P4C nationwide and internationally.

Intervention study (2022-2025)

From 2022-2025, the P4C will be implemented in Swedish elementary schools. Data collection is ongoing and about 400 pupils will be included in the project.

A non-randomized controlled intervention study design with before, after and follow up measurements is used to evaluate how effective P4C is for pupils regarding participation, well-being and mental health related quality of life in school. In particular, pupil’s engagement and occupational performance in school is seen as essential prerequisite for educational success, mental health and participation.